Healthcare Provider Details

I. General information

NPI: 1922927227
Provider Name (Legal Business Name): JOURNEY TOGETHER PEDIATRIC THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5-1 W MEADOW LN
MIDDLETOWN CT
06457-1682
US

IV. Provider business mailing address

5-1 W MEADOW LN
MIDDLETOWN CT
06457-1682
US

V. Phone/Fax

Practice location:
  • Phone: 959-225-0505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: HEATHER EMBERTON
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 317-805-1148